b Clinical Research Divisions I & II, Surgery (University), University of Manchester, Manchester

Correspondence to: R McCloy

New technologies, in particular virtual reality and robotics, will have a major impact on health care in the next decade. Clinically validated, powerful medical simulators are now available and in use across the world. General surgery leads in the use of simulators, and neurosurgery leads with augmented reality and image guided surgery. Robotics are used in orthopaedics and cardiology. Other virtual reality applications are being used in mental health, anaesthetics, and emergency medicine. Rapid developments in the internet and “e-learning” domains have accelerated the dissemination of simulation techniques, interactive 3D images, and structured courseware. This review describes the application of virtual reality and robotics to surgical training and planning and the execution of procedures in theatre and discusses the near term future of this new technology.

Methods

A successful medical simulator or surgical system based on virtual reality requires the participation of a team of specialists including experts in ergonomics and applied psychology, software engineering and digital 3D design, electromechanical engineering, robotics, and microtechnology. Consequently, no single database adequately covers all the issues involved. This review is based on our experience supplemented with data from searches of Medline and the Ergonomics Information Analysis Centre (University of Birmingham) and of the internet with various web search engines.

Historical perspective

Current virtual reality surgical systems owe their existence to pioneering developments in the early and middle 1980s. Organisations developing robots to replace humans from hostile and hazardous environments—undersea, in nuclear installations, in space, and on the battlefield—turned to an emerging technology that seemed to offer the ideal solution. The developers claimed that, with a special helmet equipped with head tracking devices and 3D displays, it was possible to create an illusion for the wearer that he or she was present in such an environment (“telepresence”) and, with a fibre optic glove, possible for them to …